Retroperitoneal para-aortic ectopic pregnancies: A review of reported cases

Objective: To gain insights into the diagnosis and treatment of retroperitoneal para-aortic ectopic pregnancies (RPEP). Methods: We conducted a review of the existing literature from the web of science, PubMed, and CNKI using the search terms ''ectopic pregnancy'' and ''retroperitoneal.'' The present review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results: After applying the inclusion and exclusion criteria, we included a total of 54 relevant works, encompassing 55 cases. The studies have revealed that a history of artificial abortion, embryo transfer, salpingectomy, and uterine cavity operation, accounted for 65.5 ​% (36/55) of the cases. Typical symptoms of RPEP include abdominal pain (43.6 ​%, 24/55) and vaginal bleeding (36.4 ​%, 20/55), with only 32.7 ​% (18/55) of cases being asymptomatic. The most common sites of RPEP are the abdominal aorta and the inferior vena cava (74.5 ​%, 41/55). There were no statistically significant differences in the incidence of acute abdomen, diameter of the pregnancy sac, number of surgeries, and the time for postoperative hCG to normalize in different pregnant site. The most effective imaging examination for RPEP was found to be abdominal ultrasound (72.7 ​%, 40/55), and the most commonly used treatment method was laparoscopy surgery (55.3 ​% ,21/38). Conclusion: It is crucial to consider the possibility of RPEP when a pregnancy mass cannot be located during routine examinations. Expanding the scope of the scan may significantly expedite diagnosis and treatment.